KREG’s Contract Management Analytics (CMA)
We've all been in this situation. You're negotiating with a payer and they hand you a proposal. "We've run the numbers" the rep says "and your payments will be about the same as they were this year." - Really?
- What data did they use?
- What's the time frame?
- Who did the analysis?
- Trust but verify! - This is an absolute must for successful negotiations. It can mean millions of dollars to your organization, positive or negative, for every managed care payer.
Do you wish you could quickly simulate all proposals using your own billing data?
With KREG Information Systems' Contract Management Analytics, CMA, you can. KREG customers increase payments by millions of dollars during contract negotiations - and so can you.
With KREG's Contract Management Analytics system you will be able to compare a proposed contract to your current contract efficiently and accurately. Having powerful simulation capabilities and the confidence to negotiate more beneficial terms is great but once the contract is negotiated and finalized, then what? With KREG you can monitor the payer's payment performance to make sure they are paying you according to the agreed upon terms. You can also analyze the payer's denials performance to see why and how often they deny claims, or what their actual effective payment rates are. During the next round of negotiations with the payer you have all this information at your fingertips.
Here is what one of our clients had to say about using CMA for contract negotiations:
Our contract negotiations are fairly straightforward. We have notebooks of cost and profitability reports by clinical service line and procedure from KREG's Cost Accounting System to show the insurance company. Our analyst is in the next room linking to KREG's CMA system. When the insurer makes a proposal we run it through the system and show the insurer the results right on the spot.
Conversely, when we propose something to them we show them the results. It doesn't take nearly as much time as it used to before we had all that information, and we are much more likely to come up with a win-win pricing structure.
CFO, KREG Client
KREG's Contract Management Analytics (CMA) uses the most accurate data possible to provide the best information to your organization. We build our database from actual scrubbed claims sent to your payers. This ensures apples to apples comparison and gives you confidence by calculating expected payments from your true claims population. Additionally, we import actual postings from your billing system or Health Information System so you can be confident the underpayment reports you look at have the correct information.
Besides the claims and postings we can load user defined fields to accommodate special calculations in your contracts. If you are interested in denials management, we can load the 835 remittance files the payers send back to you. We can also export a transaction file for loading contractuals back into your billing system.